The Patient Account Representative explains and comprehends a patient's EOB (Explanation of Benefits). Working under general supervision, this role is responsible for collecting, and posting payments to a patient’s bill. This role anticipates and acts on the needs of customers to enhance the patient experience.
Essential Job Function:
- Coordinates insurance verification, authorization and patient payment responsibility.
- Verifies accounts within two business days from evaluation or day prior to first treatment visit and secure pre-authorizations according to timely filing requirements.
- Documents verification, authorization and patient payment responsibility information on all accounts and completes accurate and timely documentation as required by each payor in the computer information system and in the patient chart.
- Identifies cases with less than adequate coverage.
- Assists with patient billing concerns and directs to financial counseling if unable to assist.
- Identifies coverage and payment options available and communicates information to patient.
- Analyzes account information notes, dates of service, chart information and takes appropriate actions according to payor requirements in order to ensure reimbursement.
- Initiates contact with payor, referral source, third party and follow up with identifying and resolving reimbursement issues.
- Performs other duties as assigned.
Education:
- Required: High School Diploma or equivalent.
Experience:
- Required: 3 years
Licensure/Certification/Listing:
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Patient Access Representatives, Medical Coders, Medical Billing Managers, Revenue Cycle Managers, Prior Authorization Specialists, Inpatient Coders, Health Information Technicians, Patient Account Representatives
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